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Minimally Invasive Donors Right Hepatectomy versus Open Donors Right Hepatectomy: A Meta-Analysis

Background: How to obtain a donor liver remains an open issue, especially in the choice of minimally invasive donors right hepatectomy versus open donors right hepatectomy (MIDRH versus ODRH). We conducted a meta-analysis to clarify this question. Methods: A meta-analysis was performed in PubMed, We...

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Autores principales: Mu, Chunyang, Chen, Chuwen, Wan, Jianghong, Chen, Guoxin, Hu, Jing, Wen, Tianfu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10146341/
https://www.ncbi.nlm.nih.gov/pubmed/37109241
http://dx.doi.org/10.3390/jcm12082904
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author Mu, Chunyang
Chen, Chuwen
Wan, Jianghong
Chen, Guoxin
Hu, Jing
Wen, Tianfu
author_facet Mu, Chunyang
Chen, Chuwen
Wan, Jianghong
Chen, Guoxin
Hu, Jing
Wen, Tianfu
author_sort Mu, Chunyang
collection PubMed
description Background: How to obtain a donor liver remains an open issue, especially in the choice of minimally invasive donors right hepatectomy versus open donors right hepatectomy (MIDRH versus ODRH). We conducted a meta-analysis to clarify this question. Methods: A meta-analysis was performed in PubMed, Web of Science, EMBASE, Cochrane Central Register, and ClinicalTrials.gov databases. Baseline characteristics and perioperative outcomes were analyzed. Results: A total of 24 retrospective studies were identified. For MIDRH vs. ODRH, the operative time was longer in the MIDRH group (mean difference [MD] = 30.77 min; p = 0.006). MIDRH resulted in significantly less intraoperative blood loss (MD = −57.86 mL; p < 0.00001), shorter length of stay (MD = −1.22 days; p < 0.00001), lower pulmonary (OR = 0.55; p = 0.002) and wound complications (OR = 0.45; p = 0.0007), lower overall complications (OR = 0.79; p = 0.02), and less self-infused morphine consumption (MD = −0.06 days; 95% CI, −1.16 to −0.05; p = 0.03). In the subgroup analysis, similar results were observed in pure laparoscopic donor right hepatectomy (PLDRH) and the propensity score matching group. In addition, there were no significant differences in post-operation liver injury, bile duct complications, Clavien–Dindo ≥ 3 III, readmission, reoperation, and postoperative transfusion between the MIDRH and ODRH groups. Discussion: We concluded that MIDRH is a safe and feasible alternative to ODRH for living donators, especially in the PLDRH group.
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spelling pubmed-101463412023-04-29 Minimally Invasive Donors Right Hepatectomy versus Open Donors Right Hepatectomy: A Meta-Analysis Mu, Chunyang Chen, Chuwen Wan, Jianghong Chen, Guoxin Hu, Jing Wen, Tianfu J Clin Med Article Background: How to obtain a donor liver remains an open issue, especially in the choice of minimally invasive donors right hepatectomy versus open donors right hepatectomy (MIDRH versus ODRH). We conducted a meta-analysis to clarify this question. Methods: A meta-analysis was performed in PubMed, Web of Science, EMBASE, Cochrane Central Register, and ClinicalTrials.gov databases. Baseline characteristics and perioperative outcomes were analyzed. Results: A total of 24 retrospective studies were identified. For MIDRH vs. ODRH, the operative time was longer in the MIDRH group (mean difference [MD] = 30.77 min; p = 0.006). MIDRH resulted in significantly less intraoperative blood loss (MD = −57.86 mL; p < 0.00001), shorter length of stay (MD = −1.22 days; p < 0.00001), lower pulmonary (OR = 0.55; p = 0.002) and wound complications (OR = 0.45; p = 0.0007), lower overall complications (OR = 0.79; p = 0.02), and less self-infused morphine consumption (MD = −0.06 days; 95% CI, −1.16 to −0.05; p = 0.03). In the subgroup analysis, similar results were observed in pure laparoscopic donor right hepatectomy (PLDRH) and the propensity score matching group. In addition, there were no significant differences in post-operation liver injury, bile duct complications, Clavien–Dindo ≥ 3 III, readmission, reoperation, and postoperative transfusion between the MIDRH and ODRH groups. Discussion: We concluded that MIDRH is a safe and feasible alternative to ODRH for living donators, especially in the PLDRH group. MDPI 2023-04-17 /pmc/articles/PMC10146341/ /pubmed/37109241 http://dx.doi.org/10.3390/jcm12082904 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Mu, Chunyang
Chen, Chuwen
Wan, Jianghong
Chen, Guoxin
Hu, Jing
Wen, Tianfu
Minimally Invasive Donors Right Hepatectomy versus Open Donors Right Hepatectomy: A Meta-Analysis
title Minimally Invasive Donors Right Hepatectomy versus Open Donors Right Hepatectomy: A Meta-Analysis
title_full Minimally Invasive Donors Right Hepatectomy versus Open Donors Right Hepatectomy: A Meta-Analysis
title_fullStr Minimally Invasive Donors Right Hepatectomy versus Open Donors Right Hepatectomy: A Meta-Analysis
title_full_unstemmed Minimally Invasive Donors Right Hepatectomy versus Open Donors Right Hepatectomy: A Meta-Analysis
title_short Minimally Invasive Donors Right Hepatectomy versus Open Donors Right Hepatectomy: A Meta-Analysis
title_sort minimally invasive donors right hepatectomy versus open donors right hepatectomy: a meta-analysis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10146341/
https://www.ncbi.nlm.nih.gov/pubmed/37109241
http://dx.doi.org/10.3390/jcm12082904
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